Evaluation of Image-Defined Risk Factor (IDRF) Assessment in Patients With Intermediate-risk Neuroblastoma: A Report From the Children’s Oncology Group Study ANBL0531

Brown EG, Adkins ES, Mattei P, Hoffer FA, Wootton-Gorges SL, London WB, Naranjo A, Schmidt ML, Hogarty MD, Irwin MS, Cohn SL, Park JR, Maris JM, Bagatell R, Twist CJ, Nuchtern JG, Davidoff AM, Newman EA, Lal DR. Evaluation of Image-Defined Risk Factor (IDRF) Assessment in Patients With Intermediate-risk Neuroblastoma: A Report From the Children’s Oncology Group Study ANBL0531. J Pediatr Surg. 2025 Jan;60(1):161896. doi: 10.1016/j.jpedsurg.2024.161896. Epub 2024 Sep 6. PMID: 39317567; PMCID: PMC11745918.

The International Neuroblastoma Risk Group (INRG) classifier utilizes a staging system based on pretreatment imaging criteria in which image-defined risk factors (IDRFs) are used to evaluate the extent of locoregional disease. Children’s Oncology Group (COG) study ANBL0531 prospectively examined institutional determination of IDRF status and compared that to a standardized central review. Between 9/2009–6/2011, patients with intermediate-risk neuroblastoma were enrolled on ANBL0531 and had IDRF assessment at treating institutions. Paired COG pediatric surgeons and radiologists performed blinded central review of diagnostic imaging for the presence or absence of IDRFs. Second blinded review was performed in cases of discordance. Comparison of local and central review was performed using the Kappa coefficient to determine concordance in IDRF assessment.